“At first it was thought that it could be a serious dengue. The studies and the tests of dengue were negative,” local health director of the Ministry of Health (Minsa), Itza Barahona, explained in a local television interview.

The children, ages 8 and 15, had the same symptoms: high fever, influenza and rash.

The director of Health wanted to reassure the population and said that Rickettsiosis is a disease for which there are antibiotics, which has “very low prevalence in Panama” and is transmitted by ticks living in rural areas and not in urban areas.

According to the ECDC, rickettsiosis/rickettsioses are a group of diseases generally caused by species of Rickettsia, a genus of obligate intracellular bacteria. Most of the Rickettsioses are transmitted by ticks, but they can also be transmitted by fleas, lice and mites.

Although they are widely distributed throughout the world, the species and associated human clinical diseases vary depending on the geographical locations. Rickettsiosis can be classified into two main groups: the spotted fever group, transmitted by ticks or mites and the typhus group, mainly transmitted by lice or fleas.